Individual provider Active NPI

Wenqiang Tian

  • Neurology Physician
  • Irvine, CA
National Provider Identifier
1376724005
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A105362 Issued in CA
Practice address
4050 Barranca Pkwy Ste 200
Irvine, CA 92604-1723
Phone
(949) 551-1090
Fax
(949) 262-5500
NPI assigned
Nov 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A105362 CA Primary
Legal Medicine 173000000X

Addresses

Primary practice location

4050 Barranca Pkwy Ste 200
Irvine, CA 92604-1723

Mailing address

4050 Barranca Pkwy Ste 200
Irvine, CA 92604-1723
Phone (949) 551-1090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120605000302 CA Practitioner - Neurology 3274797162 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

4050 Barranca Pkwy
Suite 200
Irvine, CA 92604-1723
Phone (949) 551-1090

Hospital & facility affiliations

  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603
  • Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A105362CAMDNeurology Physician

Practice roles (8 of 9)

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation CurrentSince May 12, 2019 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Mar 15, 2012 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Mar 15, 2012 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Providence Health System Southern California Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

4050 Barranca Pkwy
Ste 200
Irvine, CA 92604
Phone (949) 551-1090

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: wtian404119@direct.memorialcare.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1376724005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 BARRANCA PKWY STE 200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926041723",
            "telephone_number": "949-551-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 BARRANCA PKWY STE 200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926041723",
            "telephone_number": "949-551-1090",
            "fax_number": "949-262-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIAN",
        "first_name": "WENQIANG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-23",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A105362",
            "primary": true
        },
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.